MEDICARE: MS. BONNIE JEAN RUMBLE MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MFC31229	CA

General Provider Information

NPI Number	:	1083608111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIE JEAN RUMBLE MFT

Provider Business Mailing Address
First Line	:	1139 STRATFORD DR
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-5120
Country	:	US
Telephone Number	:	760-942-6030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2047D SAN ELIJO AVE
Second Line	:
City	:	CARDIFF BY THE SEA
State	:	CA
Zip	:	92007-1726
Country	:	US
Telephone Number	:	769-732-1539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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